Monday, April 06, 2009

Does a day ever seem like one big blur to you? Today was definitely one of those days. 45 patients and 11 hours later I have time to sit and think. What actually happened today? So many faces, so many problems. Thankfully it was a diverse day.Tonsillitis. Boils. Sickle Cell disease. Torsion of a testicle. Severe pneumonia. Malaria. Hydrocephalus. Anemia. Post-cicumcision urethral fistula. Virusses. Septic arthritis. And more.Many children could be helped. At least two are admitted for urgent medical care. Two will need to spend lots of money at the government hospital for surgical treatment. And one child likely cannot be helped.It is this one child that is now on my mind; 4 month old Ramatu. Her large head makes her problem obvious; she has hydrocephalus. Her fontanelle is bulging and her suture lines are separating.She is showing signs of raised intracranial pressure.What are the realistic options?None.Shunting can be done in places like Ghana and Kenya.But they are too far away, too expensive and require too much follow-up.Recently I learned about a new procedure: the ventriculocysternostomy.Complex, I know. It's a new technique to cure hydrocephalus without the need of a shunt.Definitely a good solution for these children.But this new procedure is only being performed in a handful of places. As far as I know, it is not available in West Africa.So while I sit here thinking of new techniques and ways to cure hydrocephalus.I am brought back reality.Ramatu's world.Sierra Leone, where this procedure is not available.News of this technique is of no help to Ramatu and her mother.And I am left with little to do.Except think, and hope, and pray.

2 comments:

Anonymous
said...

Hello Sandra, I had a child very similar to yours yesterday as well. However he was five years already, has had a shunt and just came to have it replaced. That is in the western world with all the possibilities for children. He was a lively cute boy, even with small small sedation!! What a different story to yours. I feel and pray with you for little Ramatu. Gisela